Meredith and Derek have to use more than medicine when a young Hmong woman's traditionalist, religious father forbids her to have a life-saving operation unless a shaman is called upon to "retrieve her souls". George and Alex are trapped in an elevator with a patient in critical condition after a gunshot wound to the heart. Burke tells them they must perform the surgery because there isn't enough time. Burke hands Alex the scalpel through the elevator door, but Alex freezes. George steps up and successfully gets the patient to a stable condition and the rescue team gets them out. Izzie treats an old lady who seemingly has a heart attack on the same day every year, whilst Cristina treats a man who has to watch porn to handle his pain, and has to come up with a different way to manage it when the power cuts. Derek struggles with his decision to either try to repair his marriage with Addison or divorce her and start a new life with Meredith. After trying to play it cool, Meredith breaks down and asks Derek to choose her. Ellis is discharged from the hospital.